Claim bill-cum-certificate

INDIAN NATIONAL SCIENCE ACADEMY

Bahadur Shah Zafar Marg, New Delhi 110 002
INSA Visiting Scientist Programme (FY………………..…)
CLAIM BILL-CUM-CERTIFICATE

(To be submitted in Duplicate)

INSA Sanction No.:
Candidate (Name and address):
Number of months/ days approved:
Amount claimed from the Academy:

(supported by Utilization certificate as per Institute’s format)

(subject to maximum of Rs. 30,000/- p.m. to cover boarding, lodging, travel etc.)
Bank account details of the parent institute:


Declaration
This is to be certified that I have availed the INSA Visiting Scientist Programme for FY ………………………… at ………………………………….…………………………………………………………………………… (name of the Institute visited) during the period ……….…….…..…….. to …....….…..………….. I also certify that the above statements are true, complete and correct to the best of my knowledge and belief, and in the event of any of the information being found false or incorrect or suppressed, action may be initiated against me.

(Signature of Visiting Scientist)

Endorsement by Head of the Department/Institute

UTILIZATION CERTIFICATE

FOR THE FINANCIAL YEAR __________ (visit period _________________)

(To be submitted in Duplicate)

1. 
   Title of the Research:
   
2. 
   Name of the Institution visited:
   
3. 
   Name of the Scientist:
   
4. 
   INSA Sanction letter No. & date:
   

5. 
   Head of account as given in the original sanction order:
   

6. 
   Total amount that was available for expenditure
   

(Excluding commitments) during the financial

Year

7. 
   Actual Expenditure (excluding commitments)
   

Incurred during the financial year (up to 31^st March)

8. 
   Balance amount available at the end of the financial year:
   

9. 
   Unspent balance refunded, if any
   

(Please give details of cheque no etc.)

10. 
    Amount claimed for reimbursement :
    

Certified that out of Rs. ________ of grants-in-aid sanctioned during the year __________ in favour of __________________________ vide INSA letter No. ________________________ dated __________, a sum of Rs. _________ (Rupees _______________________________) has been utilised for the purpose of research work under INSA Visiting Scientist Programme and that the balance of Rs. _____________ remaining at the end of the year has been claimed for reimbursement during the year _____________.

Signature of Scientist Finance Officer Registrar